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Author
Topic: How much faith do we put in BMI? (Read 6549 times)

Doctors recently have been focusing on my, and everyone else's BMI. This is due in part because of the recent news that HIV accelerates the aging process, and in part because many of the ARVs we take also elevate our lipids.

In some cases, like myself, there has been substantial deposition of adipose tissue, especially visceral adipose tissue, that is not beneficial for long-term health.

But, my question is, how much faith can we put in things like the BMI index which seems to lump everyone into a one-size-fits-all formula?

I have often wondered about the validity myself, and came across this article, and agree with this part of the article:

“I actually prefer to have much less focus on BMI, body composition or body weight,” says Steven Blair, a professor of exercise science at the University of South Carolina in Columbia, “and instead focus on healthful behaviors — at least 30 minutes of moderate intensity activity at least five days a week, and a diet that is focused on fruit, vegetables, whole grains and limited amounts of saturated fat and highly processed food.”

If you’re going by your body mass index, or BMI, a measure that factors in your weight and height, you are considered overweight if that score is 25 to 29, and obese if it’s 30 or higher. But a surprising new study finds that some people with a BMI pushing 28 actually have little body fat — and some folks with a BMI as low as 24 have too much.

The results question the validity of BMI, the most common measure for determining who needs to shed some pounds, says study author James Pivarnik, a professor of kinesiology and epidemiology at Michigan State University in East Lansing.

“If you’re going to classify a person as overweight by BMI, depending on who you’re working with, that may not be the best way to do it,” he says.

While prior research has found that BMI isn’t always an accurate indicator of fatness in athletes, who may be more muscle than fat, the new study is one of the first to show that BMI may not necessarily work for the general population either.

Other experts say they’ve seen this firsthand with clients, and that clearly BMI isn’t the best test for everyone. “I don’t think it’s accurate enough,” says Dr. Kenneth Cooper, founder of the Cooper Aerobics Center in Dallas.

Pinch an inch?At his facility, trainers prefer to rely on skin-fold tests that use fat calipers to measure body fat at various points, such as the back of the arm, abdomen and thighs. In addition, they use underwater weighing, a common lab test that determines how much of a person’s body is fat and how much is muscle. Other centers also use a measure called the waist-to-hip ratio , which assesses abdominal fat. Some fat is worse than others, and that around the middle is among the deadliest.

But researchers studying large populations of people rely on BMI because it’s an easy figure to calculate — they just ask people how much they weigh and how tall they are, and then do the math (weight in kilograms divided by height in meters squared). Averaged across many people, BMI is a good indicator of morbid obesity, Pivarnik says. People with a BMI pushing 40, for instance, are bound to be carrying too much around the middle, and elsewhere.

But when you look at certain individuals, BMI may be way off the mark.

In the new study, published in Medicine & Science in Sports & Exercise, the researchers calculated both BMI and body fat percentage for 439 college students.

To determine body fat, they used a BOD POD — a laboratory test that mimics underwater weighing but requires subjects to sit in a dry chamber rather than getting in water.

Study results showed that male and female college athletes, as well as male non-athletes, could have a BMI suggesting they were overweight yet still have healthy levels of body fat, defined as less than 20 percent fat in men and 33 percent in women. On the other hand, non-athlete women with a BMI indicating a normal weight could have too much body fat.

Pivarnik says large amounts of heavy muscle mass in the athletes accounts for the higher BMI, yet the athletes had low body fat because they were in shape. Even young non-athlete men could be muscular and fit yet not overly fat.

For women, the study shows, thin isn’t everything. Those who were slim yet didn’t work out to build muscle still could be quite fatty.

Pivarnik says he worries that some people, particularly young women, may find that pumping iron puts them into the overweight category per BMI, so they skip weight training altogether.

“Don’t worry about the thinness,” he says. “Worry about the working out part.”

Model thin but flabbyIndeed, many experts say that even if you can’t be model thin, it’s important to exercise.

“It’s better to be fat and fit than skinny and unfit,” says Cooper. Research at his center and elsewhere has shown this to be true.

Instead, he says, consider getting another test, such as a skin-fold, an underwater weighing or waist-to-hip ratio to more accurately determine your body fat percentage.

Ultimately, it’s more important to strive for a healthy lifestyle than to obsess about any particular number.

“I actually prefer to have much less focus on BMI, body composition or body weight,” says Steven Blair, a professor of exercise science at the University of South Carolina in Columbia, “and instead focus on healthful behaviors — at least 30 minutes of moderate intensity activity at least five days a week, and a diet that is focused on fruit, vegetables, whole grains and limited amounts of saturated fat and highly processed food.”

I don't even know why people still use BMI or even mention it. 5'11" and 210 lbs with 12% bf isn't the same as 5'11" and 210 lbs with 24% body fat percentage. You should be measuring your body fat percentage instead through BIA.

I rejected BMI ears ago, when I was a bodyboy wannabe model and my BMI was off the charts. Well, firmly ON the charts, anyhow, despite having little body fat at the time.

Ironically, I am only ten pounds heavier now, but its all fat, and I look it. Though my BMI would not differ drastically from my all-time fitness peak.

My "ideal weight" according to BMI charts is roughly 150 pounds. I DID weigh that two years ago. I was also in the hospital with PCP and had 12 CD4 cells to my name. And I looked like gaunt, drawn death.

BMI is junk science. For a doctor to promote it, especially to people with HIV, is dangerous.

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I rejected BMI ears ago, when I was a bodyboy wannabe model and my BMI was off the charts. Well, firmly ON the charts, anyhow, despite having little body fat at the time.

Ironically, I am only ten pounds heavier now, but its all fat, and I look it. Though my BMI would not differ drastically from my all-time fitness peak.

My "ideal weight" according to BMI charts is roughly 150 pounds. I DID weigh that two years ago. I was also in the hospital with PCP and had 12 CD4 cells to my name. And I looked like gaunt, drawn death.

BMI is junk science. For a doctor to promote it, especially to people with HIV, is dangerous.

Not necessarily true. If you're 5'11 and 210 with 12% body fat you are burning through a lot of calories a day in order to maintain that mass. Current research is coming out that the amount of calories you consume have a direct relation to your longevity.

Consuming so many calories to maintain a 5'11 210 12% bf is taxing on the body. Your body most work harder to burn off all that calories. Sure it may look good, but the stress is not good body if you want to live long.

Same with with being overweight. The fat around the heart and other organs makes your body work harder and wear out.

BMI is a good start to understand the range within your body PROBABLY works more efficiently. Being healthy isn't about a having a six pack and running a marathon. It's about getting the most what's given to you, and reducing the wear and tear.

Not necessarily true. If you're 5'11 and 210 with 12% body fat you are burning through a lot of calories a day in order to maintain that mass. Current research is coming out that the amount of calories you consume have a direct relation to your longevity.

Disagree, sadly. Your analysis uses a model that is rather disproportionate. An HIV positive person, on average, struggles at some time or another with body issues, image issues. You know some people stop taking meds because they get fat? Or what they perceive to be fat. I cannot begin to report the times people used to tell me that when I worked as a real-life peer counselor in Atlanta.

Look at some of us. Struggling with lipoatrophy and lipodostrophy. To those of us who have had HIV longer than a few years, BMI is not only irrelevant, it is DANGEROUS. Being a muscle-guy with low body fat DOES stress the body, sure. As does being obese. So does depriving a body of necessary nutrition in order to fit in to a category which is not appropriate for our individual body type.

With HIV eating away at our self esteem, it is not at all unusual for latent body dysmorphic disorder to manifest. And for some of us, it isn't all that latent. BMI is a DREADFUL tool that skews towards proclaiming obesity. It is as lazy as asking someone their waist size, and having them answer based on the label on their pants. And as accurate, I might add.

Granted, your advice might be somewhat sound to someone recently diagnosed, or someone infected within the last few years when the newer medications have had no impact, and on whom the illness itself has not taken a toll.

But even though I am amazed at how much I fit into the characterizations of my astrological sign, it is still junk science. BMI has little place, let alone a solitary or defining place, in the assessment of overall physical health or fitness of an HIV positive person.

If a person is "out of shape," s/he should consult with a doctor about the nuts and bolts of changing that situation, including accepting one's body type and working within the parameters not only of that, but of being HIV positive as well. Stressing one's body in order to fit into a BMI index is, I submit as dangerous as any other solution. And ultimately, as I have pointed out, an nonproductive.

JK

(who remembers "Diseased Pariah" magazine, and especially the article "Get Fat. Don't Die." And who is also, apparently, an Allosaurus as a result)

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Disagree, sadly. Your analysis uses a model that is rather disproportionate. An HIV positive person, on average, struggles at some time or another with body issues, image issues. You know some people stop taking meds because they get fat? Or what they perceive to be fat. I cannot begin to report the times people used to tell me that when I worked as a real-life peer counselor in Atlanta.

Look at some of us. Struggling with lipoatrophy and lipodostrophy. To those of us who have had HIV longer than a few years, BMI is not only irrelevant, it is DANGEROUS. Being a muscle-guy with low body fat DOES stress the body, sure. As does being obese. So does depriving a body of necessary nutrition in order to fit in to a category which is not appropriate for our individual body type.

With HIV eating away at our self esteem, it is not at all unusual for latent body dysmorphic disorder to manifest. And for some of us, it isn't all that latent. BMI is a DREADFUL tool that skews towards proclaiming obesity. It is as lazy as asking someone their waist size, and having them answer based on the label on their pants. And as accurate, I might add.

Granted, your advice might be somewhat sound to someone recently diagnosed, or someone infected within the last few years when the newer medications have had no impact, and on whom the illness itself has not taken a toll.

But even though I am amazed at how much I fit into the characterizations of my astrological sign, it is still junk science. BMI has little place, let alone a solitary or defining place, in the assessment of overall physical health or fitness of an HIV positive person.

If a person is "out of shape," s/he should consult with a doctor about the nuts and bolts of changing that situation, including accepting one's body type and working within the parameters not only of that, but of being HIV positive as well. Stressing one's body in order to fit into a BMI index is, I submit as dangerous as any other solution. And ultimately, as I have pointed out, an nonproductive.

JK

(who remembers "Diseased Pariah" magazine, and especially the article "Get Fat. Don't Die." And who is also, apparently, an Allosaurus as a result)

Jonathan, you hit on my train of thought - and why I started this thread.

My doctor will tell me "thinner is better," but doesn't harp on the BMI too much.

But I know a doctor in another nearby town who literally checks each patient's BMI on the chart and, using it, decides whether to sent them to a nutritionist, etc., to lose weight.

I just don't think someone who is HIV positive can use the BMI index as a guide. Hell I don't know that its healthy for someone who is negative.

And you were right about the body image thing too. You know what I found when I lost 12 pounds recently? Some of my old clothes fit, but the shirts still didn't. Losing weight didn't do a thing for my gut, my buffalo hump, my horsecollar neck or my chipmunk cheeks.

How odd will I look should I lose another 10 pounds yet still keep the same hump, etc.? I had hoped losing weight would diminish my hump at least. but I can't see that it has gotten smaller.

If I lost another 20 pounds, which would put me at the lower end of my BMI range and at the weight I maintained prior to my quitting smoking, imagine how I would look.

I was very pleased with myself when I went to a fitness clinic and had a dexascan to determine by BMI (which shockingly was close to 30 though you might not guess by looking at me). I was quite deflated when my doc responded that "we don't usually worry about BMI with HIV".

I personally don't put much stock in the BMI scale. According to the guidelines, I'm pathetically in the middle of the scale. I'm 5'9" and weigh 145lbs. I can't gain weight and have always been skinny. Yet, if I gain 15 lbs i'd be toward the overweight side?

Logged

Complacency is the enemy. Challenge yourself daily for maximum return on investment.

First off 15lbs is a lot of weight to pack on if you're not doing it intentionally.

BMI is supposed to be understood on a macro level. When looking at something scientifically you have to develop a working definition in order to analyze the results.

If you're BMI says your overweight and waist-hip ratio over 1.0 you're probably overweight, however under all circumstances you should consult a doctor if you believe you have a weight issue.

I urge you to re-read the thread in it's entirety.

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I have re-read the thread. Just because you don't believe it's useful doesn't mean it's useless. Like HIV drugs, mono-therapy is pretty a bad idea because it will cause the virus to mutate quickly and render the drug useless, it's has been determined that a combination of three drugs are optimal.

As a singular tool BMI is not a useful tool in determining obesity, but guess what, there's not one singular measurement out there to determine the correct weight for an individual. Even BIA or BFP are cross referenced with the BMI in order to determine ideal weight when for individuals, because BIA and BFP can only tell you what you percentage is, it cannot determine what weight you should be.

I'll echo my sentiments here as well - BMI is not a great way to measure health or even where one might fit on the weight scale. If one is to use strictly a chart w/ me, for example, I'd be "obese" but if you saw me, you'd laugh at that diagnosis. My doctor wants me to be between 215 and 225 lbs. I currently sit at 240-ish. I have a small gut, a gut nonetheless, but the way my body is structured (very broad chest/shoulders) totally throws out the model as a one-size-fits-all type deal.

Of course being that I'm new to the world of HIV, I have to rethink (as does my physician) what is right for me. But 6 months ago, at 6'2" my doctor said 215-225 is more than ideal for me. Going by the BMI scale, I should be around 185. I'd be terrified to see me at 185. I'd be a freakin skeleton.

I recently discovered something that may be the reason why people are thrown off by the BMI.Most people I know don't know their correct height!There is usually a scale for height at the doctors office. Take your shoes off and see what your true height is, it may not be the height you may have thought for years......Recently I realized that I am actually 5'7" which is an inch shorter than I believed fir the past 25 years.At 47 I doubt if that inch was lost in shrinkage.Being male, I probably added an inch....................... AOL height!

I hope the thread where I was complaining about my weight gain doesn't get resurrected. I was complaining about hitting 150 lbs and that was now 10 pounds ago.

I command this thread to raise from the dead.

Logged

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

You know I have a spot reserved for you at the church that Betty and I opened earlier this week.

Logged

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts